Provider Demographics
NPI:1861850851
Name:AHMED, HUMAA (PA)
Entity Type:Individual
Prefix:MRS
First Name:HUMAA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8126
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7603
Mailing Address - Fax:314-362-5470
Practice Address - Street 1:4921 PARKVIEW PL STE 5C
Practice Address - Street 2:STE 5C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-7603
Practice Address - Fax:314-362-5470
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2018-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2017005950363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant